Delusions

I have ptsd and borderline. This winter, I had a phase of four months in which I had delusions. The delusions entailed having somebody else’s presence in my head, up to the point where this presence (while being in my head) wanted to kill me or wanted me to kill myself.

People have suggested schizophrenia but I’m certain I don’t have that, because I don’t switch between personalities. I just feel like people (they’re always people who already exist) get into my head and then “take over”. Is there any recognized disorder with this symptom?

A. It’s important to correct a common myth about schizophrenia. Some people believe that people with schizophrenia have split personalities, like the famous fictional characters Dr. Jekyll and Mr. Hyde. They seem to be confusing dissociative identity disorder (DID) with schizophrenia. Individuals with schizophrenia do not have split personalities.

DID and schizophrenia are two distinctly different disorders. The essential features of DID are memory loss, amnesia and multiple non-integrated personalities. People with schizophrenia do not have those symptoms. They commonly experience delusions, hallucinations and paranoia. Psychosis can cause someone to behave abnormally, and it can alter their personality. The changes in behavior and personality caused by psychosis might be why some people continue to believe in the idea of “split personalities” among people with schizophrenia.

In your case, you believe that you experienced a delusion. Delusions are a symptom of schizophrenia, but if it were your only symptom you would not receive a diagnosis of schizophrenia. A schizophrenia diagnosis requires at least two major psychotic symptoms, that are present for the majority of one month.

It’s possible that you did not experience a delusion. It may have been paranoia or a dissociative symptom related to your current diagnosis. Dissociative symptoms, such as depersonalization and derealization, are associated with both posttraumatic stress disorder and borderline personality disorder.

My recommendation is to consult your treating mental health professionals. They have intimate knowledge of your psychosocial history and can offer suggestions about treatment, if necessary. It’s important for your treatment team to be aware of all symptom changes and concerns. Please take care.

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Last reviewed: By Psych Central Staff on 8 May 2014Originally published on PsychCentral.com on 9 May 2014. All rights reserved.